Effects of gustatory stimulation on brain activity during hunger and satiety in females with restricting-type anorexia nervosa: An fMRI study

Background: Previous research has demonstrated altered neuronal responses to visual stimulation with food in anorexia nervosa, varying with the motivational state of hunger or satiety. The aim of the present fMRI study was to assess hunger- and satiety-dependent alterations in the gustatory processing of stimulation with food in anorexia nervosa. Methods: After food abstention (hunger condition) and after eating bread rolls with cheese (satiety condition), 12 females with restricting-type anorexia nervosa and 12 healthy females drank chocolate milk and water via a tube in a blocked design during image acquisition. Additionally, heart rate was registered during the measurements, and subjective ratings of hunger/satiety and of the valence of chocolate milk were assessed using a Likert scale. Results: In participants with anorexia nervosa, drinking chocolate milk in the hunger condition induced significant activations in the right amygdala and in the left medial temporal gyrus relative to healthy controls. When contrasting neuronal responses to drinking chocolate milk during satiety with those evoked during hunger, a significant activation was found in the left insula in healthy controls, whereas in participants with anorexia nervosa, neuronal activity in the inferior temporal gyrus, covering the extrastriate body area, was observed. Conclusions: Neuronal responses evoked by gustatory stimulation differ depending on hunger and satiety. Activations located in the amygdala and in the extrastriate body area might reflect fear of weight gain, representing one of the core symptoms of anorexia nervosa. (C) 2010 Elsevier Ltd. All rights reserved.